{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T12:02:18Z","timestamp":1776772938252,"version":"3.51.2"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":43,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"California Breast Cancer"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Harm associated with persistent opioid use beyond the first-year intensive cancer treatment is underinvestigated in cancer survivors. We examined rates and risk factors for persistent opioid use and all-cause mortality after the first-year breast cancer survivorship.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective cohort study used electronic health record data from Kaiser Permanente Southern California for women diagnosed with a nonmetastatic breast cancer between 2009 and 2019 who filled 2 or more opioid prescriptions. Rates of persistent opioid use were estimated from first-year survivorship through December 31, 2021. Rate ratios (RRs) and 95% confidence intervals (CIs) for factors associated with persistent use were estimated using a multivariable Poisson regression model. Hazard ratios (HRs) for all-cause mortality associated with persistent opioid use were estimated using multivariable Cox regression models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 14\u2009347 eligible individuals (mean [SD] age = 61.9 [12.5]), 2285 (15.9%) developed persistent opioid use, with an incident rate of 25.5 per 1000 person-years. Risk factors included older age (\u226565 vs &amp;lt; 65\u2009years: RR\u2009=\u20091.63, 95% CI\u2009=\u20091.24 to 2.14), smoking (current: 1.89, 1.68 to 2.13; former: 1.30, 1.20 to 1.41), baseline comorbidities (Elixhauser Comorbidity Index 5+ vs 0: 1.70, 1.29 to 2.24), and substance use disorders (1.58, 1.43 to 1.74). All-cause mortality was doubled among individuals with persistent use (51.6, 48.0 to 55.6 per 1000 person-years) than in those without (25.3, 24.2 to 26.4). Persistent use was associated with an increased all-cause mortality (adjusted HR\u2009=\u20091.84, 1.66 to 2.04).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Persistent opioid use was common in breast cancer survivors and associated with increased mortality. Further research is needed to explore factors that may be contributing to increased mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jncics\/pkaf060","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T15:22:49Z","timestamp":1749741769000},"source":"Crossref","is-referenced-by-count":2,"title":["Persistent prescription opioid use and all-cause mortality following the first-year breast cancer survivorship"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8684-6506","authenticated-orcid":false,"given":"Rulin C","family":"Hechter","sequence":"first","affiliation":[{"name":"Department of Research & Evaluation, Kaiser Permanente Southern California , Pasadena, CA,","place":["United States"]},{"name":"Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine , Pasadena, CA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0989-7144","authenticated-orcid":false,"given":"Lie Hong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Research & Evaluation, Kaiser Permanente Southern California , Pasadena, CA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8397-3729","authenticated-orcid":false,"given":"Jiaxiao","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Research & Evaluation, Kaiser Permanente Southern California , Pasadena, CA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5874-190X","authenticated-orcid":false,"given":"Zheng","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Research & Evaluation, Kaiser Permanente Southern California , Pasadena, CA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7579-7076","authenticated-orcid":false,"given":"Moira","family":"Brady-Rogers","sequence":"additional","affiliation":[{"name":"Alive & Well Women , South Pasadena, CA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4212-6184","authenticated-orcid":false,"given":"Rowan T","family":"Chlebowski","sequence":"additional","affiliation":[{"name":"The Lundquist Research Institute for Biomedical Innovation, UCLA-Harbor , Torrance, CA,","place":["United States"]},{"name":"Division of Medical Oncology and Hematology, UCLA-Harbor , Torrance, CA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8563-3330","authenticated-orcid":false,"given":"Reina","family":"Haque","sequence":"additional","affiliation":[{"name":"Department of Research & Evaluation, Kaiser Permanente Southern California , Pasadena, CA,","place":["United States"]},{"name":"Department of Health Systems Science, Kaiser Permanente Bernard J. 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